Maine DHHS COVID-19 Vaccines Information for Clinicians - Stephen Sears MD, MPH, Maine CDC - Maine.gov

Maine DHHS

     COVID-19 Vaccines
  Information for Clinicians
  Stephen Sears MD, MPH, Maine CDC
Lisa M. Letourneau MD, MPH, ME DHHS

           April 27, 2021

Welcome

• Introductions
• Session goals & format
• CME available (0.5 AMA PRA Cat 1 Credit/session)
  If CME desired, pls email your name & session
   attended to COVIDCME.DHHS@maine.gov
• Future sessions
• Current context

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Disclosures

The planners and faculty for this activity do not
  have any relevant financial relationships to
disclose with any Commercial Interests and do
  not have any conflicts of interest to resolve

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UPDATE!
• COVID-19 Vaccine Clinician Info Sessions
  moving in April to twice/monthly schedule
• Will host sessions on 2nd & 4th weeks/month
  – Tues 7:30AM (April 27, May 13 & onward)
  – Fri 12N (Apr 30, May 16 & onward)
• Will continue to record & post on CDC website
• Will also continue to host ME DHHS Health
  Equity webinar on 3rd Wed/mo (7:30AM)

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COVID-19 Vaccines – Info for Clinicians
•   Context
•   Science of vaccines
•   Clinical trials & emerging vaccines
•   Vaccine updates: J&J vaccine
•   Addressing clinical questions
•   Reporting & tracking adverse events
•   Impact of viral variants
•   Promoting vaccine equity
•   Building vaccine confidence
•   State vaccination priorities & distribution efforts
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J&J COVID-19 Vaccine: Last Week
• On Apr 13, US CDC & FDA recommended “pause” on
  use of J&J/Janssen COVID-19 vaccine to review data
  & potential actions
• Pause triggered by identification of 6 cases of
  cerebral venous sinus thrombosis (CVST) identified in
  combination with thrombocytopenia, w/ 1 death
  following administration of 6.85M doses of J&J
  vaccine
• All J&J vaccine use in Maine halted as of Apr 13
  pending ACIP review of data & FDA/US CDC update
      https://www.cdc.gov/media/releases/2021/s0413-JJ-vaccine.html
            https://emergency.cdc.gov/han/2021/han00442.asp           6

J&J COVID-19 Vaccine: This Week
• Fri, Apr 23, US CDC & FDA lifted “pause” on use of
  J&J/Janssen vaccine following addnl review data &
  recommendation from ACIP
• Determined J&J vaccine benefits outweigh risks
• Addnl review identified total 15 cases of thrombosis-
  thrombocytopenia syndrome (TTS) following admin of 7.1M
  doses of J&J vaccine (includes original 6 cases)
• All of cases occurred in women between 18-59yo, with
  median age 37 yo; sx onset was 6-15D post-vaccination
• No cases of CVST have been reported in Maine
• Maine restarted use of J&J vaccine on Apr 24
www.fda.gov/news-events/press-announcements/fda-and-cdc-lift-recommended-pause-
         johnson-johnson-janssen-covid-19-vaccine-use-following-thorough     7

Thrombosis Thrombocytopenic Syndrome (TTS)

    https://www.cdc.gov/vaccines/acip/meetings/slides-2021-04-23.html   8

Management of TTS

https://www.cdc.gov/vaccines/acip/meetings/slides-2021-04-23.html   9

J&J COVID-19 Vaccine & TTS:
        US CDC COCA Call Tues, 4/27, 2PM

www.zoomgov.com/j/1601111927?pwd=UTliM1BEWnJ0SkpKUzZnZUVDTVBxUT09#success
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J&J Vaccine: Benefits Outweigh Risks

 https://www.cdc.gov/vaccines/acip/meetings/slides-2021-04-23.html   11

Reporting Adverse Events to VAERS

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Re-Starting J&J & Vaccine Confidence
• US saw 20% decrease in COVID vaccinations
  during period of J&J pause
• Getting J&J back into use is critical
• Key messages following J&J “pause” & re-release
  – All authorized COVID vaccines are extremely safe
  – J&J vaccine remains extremely safe
  – TTS is rare event, >2 cases/1M vaccinated
  – Safety monitoring system (VAERS) works
  – Risks of not getting vaccinated far outweigh risks of
    getting COVID                                         13

(Re)Building Vaccine Confidence
Suggested key messages for clinicians from Dr Tom
Frieden:
• COVID vaccines up to 95% effective, even more than annual
  flu vaccine, which is typically 40%-60% effective
• If people are vaccinated, we can prevent 100,000 or more
  deaths from COVID
• Nearly all doctors who have been offered vaccine have
  taken it
• If you get infected with COVID, it’s much more likely to
  cause you long term problems than getting vaccinated.
• The more we vaccinate, the safer it will be to see family
  and friends                                               14

Maine Plan for Vaccine Distribution*
         Phase 1a
 •   Health Care
     Personnel                                        All Other
 •   Residents & staff            • Current:
     of long-term care              • All individuals 16yo & older
     facilities
 •   Public safety
 •   State COVID
     response critical
     personnel

*Updates posted to Gov Mills COVID Vaccine website: www.maine.gov/covid19/vaccines
NOTE: Facilities booking appts listed at: www.maine.gov/covid19/vaccines/vaccination-sites

Health Equity “Pop-Up” Clinics
• Community partners invited to apply to host Pop-
  Up clinics to improve vaccine confidence & access
  for underserved communities
• Selected organizations linked with MIP-approved
  vaccine provider
• Community sponsors select physical location, plan
  logistics, provide staff or volunteers on site to serve
  as greeters, cultural brokers, interpreters
• Vaccine providers work with community sponsors to
  coordinate scheduling & ensure clinical and support
  staff
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Ensuring Racial/Ethnic Equity
ME DHHS Equity webinar Wed, May 19, 7:30A
• Register in advance for this and additional
  webinars in monthly series:
  https://zoom.us/meeting/register/tJcsfuGvpj0jGda
  RiW5Y15qnYa2AMVriHgaI , OR
• Log on at the time of the webinar with
  following link: https://zoom.us/j/93198786932
   – Meeting ID: 931 9878 6932
   – Passcode: 4FrT7H
   – One tap mobile:
     +13126266799,,93198786932#,,,0#,,416363#

*NOTE: Clinician Info Sessn’s now being held on
  2nd & 4th Tues (7:30A) & Fri (12N) each month
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Updates for Vaccine Point-of-Distribution
              (POD) Sites
• Encouraging POD sites to accept walk-in’s
• Note MidCoast “Golden Ticket” concept to
  provide for rapid vaccine access following primary
  care-patient conversations
• State will now support special POD clinics for
  workers, esp. those at increased COVID risk, &
  for students in higher education settings
• However, such clinics will need to be planned
  with regular vaccine supply
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New State Vaccination Efforts: FEMA MVU
• FEMA Mobile Van Units (MVU) hosting mobile clinics
  around Maine over next ~2 months
• Currently: Biddeford
• Next wk: Fryeburg (Apr 30 – May 3), Turner
• Now again offering J&J vaccine
• (Apr 13 – 23 used Moderna – 2nd doses TBD)
• Vaccination by appointment + walk-up
• Doing ~300-500+ vaccinations/day
• Appts can be sched’d via ME Community Vaccination
  Line: tel. 1-888-445-4111 or VaccinateME.maine.gov
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Community Vaccination Call Line
• Community Vaccination Line: tel. 1-888-445-4111
• Available M-F: 7A -7P, & Sat-Sun: 8A - 2P
• Can help those who…
  – Do not have internet access
  – Need assistance connecting to or navigating online
    resources
  – Require interpretation assistance
  – Are home bound and need transportation
  – Have other questions about resources in their area
• Will not provide faster access to clinic appts
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Transportation Assistance
• Maine DHHS offering free transportation to
  anyone needing ride to vaccination appt
• Indiv’s must first schedule vaccine appt
• Those with vaccine appt can schedule rides by
  calling tel. 1-855-608-5172 (Mon-Sat, 7A – 4P)
• Need to call at least 48hrs before vaccine appt
• Managed by ModivCare (formerly LogistiCare),
  with contracts to CAPs & other agencies
• Drivers will leave pts for appt, return at 60’ or 90’
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Gov Mills Info COVID Vaccine

      www.maine.gov/covid19/vaccines   22

Gov Mills Info COVID Vaccine

      www.maine.gov/covid19/vaccines   23

Gov Mills Info COVID Vaccine

      www.maine.gov/covid19/vaccines   24

UPDATE!
• COVID-19 Vaccine Clinician Info Sessions
  moving in April to twice/monthly schedule
• Will host sessions on 2nd & 4th weeks/month
  – Tues 7:30AM (April 27, May 13 & onward)
  – Fri 12N (Apr 30, May 16 & onward)
• Will continue to record & post on CDC website
• Will also continue to host ME DHHS Health
  Equity webinar on 3rd Wed/mo (7:30AM)

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ME CDC COVID Vaccine Resources

                        ME CDC COVID-19 Vaccine Resources
(www.maine.gov/dhhs/mecdc/infectious-disease/immunization/covid-19-providers/index.shtml)
                                Vaccine questions? Email:
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                              C19vaccine.MECDC@maine.gov

Presenters

• Lisa Letourneau MD, MPH
  Senior Advisor, Healthcare Delivery System Change, ME DHHS
  Lisa.Letourneau@maine.gov
  C: 207-415-4043

• Stephen Sears MD, MPH
 Consulting Epidemiologist, Maine CDC
 Stephen.sears@maine.gov
 C: 207-458-2351

                   Maine Department of Health and Human Services   27

COVID-19 Vaccines

  Questions??

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